A low I hadn't noticed before

IanBish

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I have a new (to me) CGM on (Libre 2 Plus) and after my sourdough salmon sandwich for lunch my blood sugar went up (obviously). After a few hours the CGM showed that my glucose was low, which was confirmed with a finger prick. I felt quite tired so grabbed the only carby thing I had (an apple) and soon felt more normal. Because I don't wear a CGM that often I don't know if this has happened before. I was just wondering if this was normal after a carby meal (the sandwich). An extract of the CGM graph is below.

share_4994350247825235424.jpg
 
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Lamont D

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I have a new (to me) CGM on (Libre 2 Plus) and after my sourdough salmon sandwich for lunch my blood sugar went up (obviously). After a few hours the CGM showed that my glucose was low, which was confirmed with a finger prick. I felt quite tired so grabbed the only carby thing I had (an apple) and soon felt more normal. Because I don't wear a CGM that often I don't know if this has happened before. I was just wondering if this was normal after a carby meal (the sandwich). An extract of the CGM graph is below.

View attachment 70202
Is this your first wearing of a cgm?
Is this your first awareness of a low reading at all?
Did you get symptoms?
Do you know if the CGM is calibrated etc?

To me, I would expect the gradual raising of BG levels and the good curve downwards, but the low is not usual, unless, your normal response is to go slightly low.
If it is a one time thing, then it shouldn't be a concern however, if it happens every day after carbs, that is a different matter.
do keep track of your BG levels.
@IanBish was your finger prick a low?
what did you take to bring you out of the low?
are you okay now?
 
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IanBish

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Is this your first wearing of a cgm?
Is this your first awareness of a low reading at all?
Did you get symptoms?
Do you know if the CGM is calibrated etc?

Was your finger prick a low?
What did you take to bring you out of the low?
Are you okay now?
I've worn about four CGMs before.
I've had compression lows during the night previously.
I felt quite tired.
I didn't calibrate it. I don't think I can.

My finger prick showed 3.5 mmol/L.
I ate an apple (the only carbs I had to hand).
I'm fine now, thanks.

I don't believe this to be a problem, but I'll keep an eye on things.
 
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Lamont D

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I do not have diabetes
I've worn about four CGMs before.
I've had compression lows during the night previously.
I felt a quite tired.
I didn't calibrate it. I don't think I can.

My finger prick showed 3.5 mmol/L.
I ate an apple (the only carbs I had to hand).
I'm fine now, thanks.

I don't believe this to be a problem, but I'll keep an eye on things.
keep the readings for future reference to your doctor if necessary.
The recovery was fine. The apple was a good choice.
But for future reference, the idea, if you do get frequent hypos, is to not to eat the carbs that cause the reaction in the first place.
I know.
 
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HairySmurf

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So far (after four sensors) the only lows I've noticed were due to alcohol or immediately after exercise. I have noticed that moderate exercise done toward the 'end of the curve' can push my BG levels down very rapidly. I'd get home and within minutes they'd pop back up quickly. Apart from that there was always alcohol involved. You would not believe the effect alcohol has on me when eating lots of carbs. Once I saw the effect twice while experimenting and realised what I was seeing I spent an entire week drinking my ass off and eating ridiculous amounts of carbs just to see how big the alcohol effect is for me. Massive, unbelievable. It seems that so long as I have a couple of drinks before eating carbs, and then keep drinking, I can handle massive amounts of carbs without producing a big spike. Also very dangerous because now I have in it my head that I can just get drunk on dry white wine and eat whatever I like. Not good. Not good at all. I have no idea how big a role the meds I'm on play though. Is the alcohol just increasing the effects of the meds, or is it the alcohol alone? No idea. I won't know until I get off the meds, if that happens. I assume you weren't drinking between 4pm and 6pm though and as you had eaten a substantial meal so I have zero clue at to what might have caused that.
 

IanBish

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Thanks for the replies.

There was no alcohol involved in the low mentioned, though I am aware of that effect. I did have some lows during the night, but I don't know if they were compression lows or not. My current number is 4.9 mmol/L, so I'll see how it goes after a non-carby lunch.
 
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Chris24Main

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@IanBish - Of course there is a danger in saying anything is normal, but this is certainly what you should expect to be happening from a purely metabolic perspective - with any insulin response like this (not using the "spike" term, nothing abnormal per se about the response) - you should expect to exit the "response" with a lower blood glucose level (and a higher insulin level) that when you started.

ie, carbs from the sourdough are piped into your liver, triggering pancreas to increase insulin. Insulin triggers tissue to take in more glucose, glucose level drops. When blood glucose gets low, pancreas stops producing insulin. The balance and timing of this all depends on exactly how sensitive you are with sourdough and insulin resistance.. This is really the trail of events that explains why snacking to "give you a boost" is often the opposite of what actually happens.. you end up with less energy.

Depending on you, personally, you may or may not benefit from that apple to "restore" your blood glucose, but it's likely (at least in my experience, which is quite old now) that you would see the same glucose raise back no normal background, as your insulin levels go back to normal. There is also the effect of stress that comes with looking at that red line appearing - just try to remember that low blood glucose in a T2 is not quite the same thing as low (and dropping) blood glucose in a T1. (though, I do totally get that feeling of being unwell and tired).

Alcohol is a whole other issue, with alcohol around, your liver must metabolise that before anything else.

4.9 is an excellent level by the way. Good work...
 

IanBish

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I appreciate what you've written, @Chris24Main, and I would have expected a sugar crash to happen if I'd eaten whole bar of standard chocolate, which I used to do fairly often prior to diagnosis. But I've had sourdough bacon sarnies before, without this sort of issue. So I guess it's a one-off.

On the plus side, the apple I had to try to compensate only increased my blood sugar to about 5 mmol/L, so that's good news I guess.
 
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Chris24Main

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Hey.. just in case I've come over critical.. don't mean to be at all.. I'm not even saying this is a sugar crash, just that it's much more what you would expect.
Don't forget.. a bacon sarnie is a different game, because you have a lot more fat in the bacon.. salmon is going to be all protein.. so you know now that you have a different response to the protein and starch in a salmon sourdough compared to a bacon sarnie.. all good.
 
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IanBish

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Hey.. just in case I've come over critical.. don't mean to be at all.
I didn't think that at all.
Don't forget.. a bacon sarnie is a different game, because you have a lot more fat in the bacon.. salmon is going to be all protein.
The bacon wasn't all that fatty, and there's a fair bit of fat in tinned salmon, isn't there? Plus I used a fair bit of butter on the sourdough too.
 

Chris24Main

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Looks like you have the perfect excuse for another Salmon sourdough, and a bacon sarnie then...!
If in doubt, repeat!
And I have to stop talking about salmon sourdough, I get a ripple of salivation every time I think of it..
 

IanBish

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I have sourdough maybe once a week, so I'll have a salmon or bacon sarnie next week and keep an eye on my blood sugar.
 

IanBish

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It happened again. I had one (fairly big) slice of sourdough with three rashers of bacon. A few hours later I started to feel a bit tired and my glucose was 3.5 mmol/L. I understand that the fat would have lessened (but probably extended) the curve, but why would that give me a low afterwards? I know @Lamont D said to avoid whatever I ate, but I just wondered why. I've added an extract of the relevant CGM graph below. The second "spike" was a pint I had after work.

share_6219396658530456114.jpg
 
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searley

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I have a new (to me) CGM on (Libre 2 Plus) and after my sourdough salmon sandwich for lunch my blood sugar went up (obviously). After a few hours the CGM showed that my glucose was low, which was confirmed with a finger prick. I felt quite tired so grabbed the only carby thing I had (an apple) and soon felt more normal. Because I don't wear a CGM that often I don't know if this has happened before. I was just wondering if this was normal after a carby meal (the sandwich). An extract of the CGM graph is below.

View attachment 70202
for someone thats not on BG lowering meds like insulin then normal bg levels are considered to be more than 3.9

bg meters and cgms, have a 'margin of error'. ie, a reading of 3.5 on a meter could easily be 3.9 in the real world

without bg lowering drugs, its unlikely your bg would continue to drop, but if you feel any of the symptoms of low blood sugar check your BG
 

IanBish

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bg meters and cgms, have a 'margin of error'. ie, a reading of 3.5 on a meter could easily be 3.9 in the real world

without bg lowering drugs, its unlikely your bg would continue to drop, but if you feel any of the symptoms of low blood sugar check your BG
My CGM, my BG reading, and my body all said my glucose was low. I feel much better when my blood glucose level is around 4.5 mmol/L, which it normally is in a fasted state.
 
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Lamont D

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It happened again. I had one (fairly big) slice of sourdough with three rashers of bacon. A few hours later I started to feel a bit tired and my glucose was 3.5 mmol/L. I understand that the fat would have lessened (but probably extended) the curve, but why would that give me a low afterwards? I know @Lamont D said to avoid whatever I ate, but I just wondered why. I've added an extract of the relevant CGM graph below. The second "spike" was a pint I had after work.

View attachment 70253
I do agree with @searley, did you check your BG levels with a finger prick.
And it only went to 3.5mmols.
I'm saying that because of the leeway you do have to accept with BG monitoring.

But it does show how quickly you spiked from the sourdough bread, you actually doubled your levels from before eating.
Your insulin response did eventually bring it back into normal and it took four hours to get back into normal levels, at two hours after it was 3 mmols higher, which is just over where it is recommended, so not that bad, the beer was very acceptable.
What was it? Ha!

To be honest, if that was someone who hasn't had a diagnosis, I would say that it looks very reasonable.
The graph has no real sinister aspects, excepting that it takes longer than usual to get back into normal BG levels. And is slightly lower than what is considered normal.

But I would still keep an eye on it, reduce the portion size of the bread.

Best wishes.
 

Lamont D

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My CGM, my BG reading, and my body all said my glucose was low. I feel much better when my blood glucose level is around 4.5 mmol/L, which it normally is in a fasted state.
What are your symptoms when you first feel as if you are going low?
Before you finger test?
And look at the readout of the graph?
I'm just interested, for my experience of low blood glucose levels.
 

Antje77

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and my glucose was 3.5 mmol/L.
Confirmed with a fingerprick or CGM only?
It happened again. I had one (fairly big) slice of sourdough with three rashers of bacon. A few hours later I started to feel a bit tired and my glucose was 3.5 mmol/L. I understand that the fat would have lessened (but probably extended) the curve, but why would that give me a low afterwards?
First, going below 4 occasionally isn't abnormal in non diabetics, and I wouldn't do too much thinking about it if it were me and the only symptom was feeling a bit tired.
For what it's worth, at some point in the late 1990's I dated a guy with T1, some 20 years before I developed diabetes myself. At the time I had an inkling that non diabetics could go lowish and he didn't believe me.
So I waited until one of those moments where I felt 'hangry'; irritable and not quite well with a strong sense of needing to eat something, and I used his meter to test. It showed me a 3.2, proving my point.

With (minor) symptoms to go with your graphs, you might want to look into first and second phase insulin response.
If the first phase is sluggy, the second phase may wake up with a jolt due to the sharpish rise, and slightly overdo its thing, resulting in a minor low.

If this were me, I would be slightly amused by this and not worry.
 
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IanBish

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But I would still keep an eye on it, reduce the portion size of the bread.

Best wishes.
I'm almost out of sourdough, and I will, thanks.
What are your symptoms when you first feel as if you are going low?
Before you finger test?
I felt a bit tired and lethargic and a little bit shaky.
Confirmed with a fingerprick or CGM only?
In the first post I confirmed with a fingerprick, but not this time. Though it felt similar.
 

Lamont D

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I'm almost out of sourdough, and I will, thanks.

I felt a bit tired and lethargic and a little bit shaky.

In the first post I confirmed with a fingerprick, but not this time. Though it felt similar.
Those symptoms are very similar to what is commonly known as a sugar crash.
It happens when your body uses too much Insulin and overproduction of insulin is not good.
The symptoms are what is telling your body to adjust to the low levels. It's your brain sending signals to your organs and glands to the response of the first phase and subsequent BG levels.

There are probably many on here who have had similar experiences.

But do keep an eye on it.
Maybe do a little experiment, to see what other carbs do to your BG levels?